CLIENT/VISITOR CONTACT TRACING FORM CLIENT/VISITOR CONTACT TRACING FORM CLIENT/VISITOR CONTACT TRACING FORM

FULL NAME: DATE OF VISIT: FULL NAME: DATE OF VISIT: FULL NAME: DATE OF VISIT:
COMPLETE CURRENT ADDRESS: TIME OF VISIT: COMPLETE CURRENT ADDRESS: TIME OF VISIT: COMPLETE CURRENT ADDRESS: TIME OF VISIT:
PURPOSE OF VISIT: PURPOSE OF VISIT: PURPOSE OF VISIT:
MOBILE/PHONE NUMBER: MOBILE/PHONE NUMBER: MOBILE/PHONE NUMBER:
E-MAIL ADDRESS: E-MAIL ADDRESS: E-MAIL ADDRESS:

I hereby authorize Mactan National High School, to collect and process the data
indicated herein for the purpose of contact tracing effecting contro of the COVID-19
transmission. I understand that my personal information is protected by RA 10173 or
the Data Privacy Act of 2012 and that this form will be destroyed 30 days from date of
accomplishment, following the National Archives of the Philippines protocol.
I hereby authorize Mactan National High School, to collect and process the data
indicated herein for the purpose of contact tracing effecting contro of the COVID-19
transmission. I understand that my personal information is protected by RA 10173 or
the Data Privacy Act of 2012 and that this form will be destroyed 30 days from date of
accomplishment, following the National Archives of the Philippines protocol.
I hereby authorize Mactan National High School, to collect and process the data
indicated herein for the purpose of contact tracing effecting contro of the COVID-19
transmission. I understand that my personal information is protected by RA 10173 or
the Data Privacy Act of 2012 and that this form will be destroyed 30 days from date of
accomplishment, following the National Archives of the Philippines protocol.

Signature:__________________________ Signature:__________________________ Signature:__________________________

CLIENT/VISITOR CONTACT TRACING FORM CLIENT/VISITOR CONTACT TRACING FORM CLIENT/VISITOR CONTACT TRACING FORM

FULL NAME: DATE OF VISIT: FULL NAME: DATE OF VISIT: FULL NAME: DATE OF VISIT:
COMPLETE CURRENT ADDRESS: TIME OF VISIT: COMPLETE CURRENT ADDRESS: TIME OF VISIT: COMPLETE CURRENT ADDRESS: TIME OF VISIT:
PURPOSE OF VISIT: PURPOSE OF VISIT: PURPOSE OF VISIT:
MOBILE/PHONE NUMBER: MOBILE/PHONE NUMBER: MOBILE/PHONE NUMBER:
E-MAIL ADDRESS: E-MAIL ADDRESS: E-MAIL ADDRESS:

I hereby authorize Mactan National High School, to collect and process the data
indicated herein for the purpose of contact tracing effecting contro of the COVID-19
transmission. I understand that my personal information is protected by RA 10173 or
the Data Privacy Act of 2012 and that this form will be destroyed 30 days from date of
accomplishment, following the National Archives of the Philippines protocol.
I hereby authorize Mactan National High School, to collect and process the data
indicated herein for the purpose of contact tracing effecting contro of the COVID-19
transmission. I understand that my personal information is protected by RA 10173 or
the Data Privacy Act of 2012 and that this form will be destroyed 30 days from date of
accomplishment, following the National Archives of the Philippines protocol.
I hereby authorize Mactan National High School, to collect and process the data
indicated herein for the purpose of contact tracing effecting contro of the COVID-19
transmission. I understand that my personal information is protected by RA 10173 or
the Data Privacy Act of 2012 and that this form will be destroyed 30 days from date of
accomplishment, following the National Archives of the Philippines protocol.

Signature:__________________________ Signature:__________________________ Signature:__________________________

CLIENT/VISITOR CONTACT TRACING FORM CLIENT/VISITOR CONTACT TRACING FORM CLIENT/VISITOR CONTACT TRACING FORM

FULL NAME: DATE OF VISIT: FULL NAME: DATE OF VISIT: FULL NAME: DATE OF VISIT:
COMPLETE CURRENT ADDRESS: TIME OF VISIT: COMPLETE CURRENT ADDRESS: TIME OF VISIT: COMPLETE CURRENT ADDRESS: TIME OF VISIT:
PURPOSE OF VISIT: PURPOSE OF VISIT: PURPOSE OF VISIT:
MOBILE/PHONE NUMBER: MOBILE/PHONE NUMBER: MOBILE/PHONE NUMBER:
E-MAIL ADDRESS: E-MAIL ADDRESS: E-MAIL ADDRESS:

I hereby authorize Mactan National High School, to collect and process the data
indicated herein for the purpose of contact tracing effecting contro of the COVID-19
transmission. I understand that my personal information is protected by RA 10173 or
the Data Privacy Act of 2012 and that this form will be destroyed 30 days from date of
accomplishment, following the National Archives of the Philippines protocol.
I hereby authorize Mactan National High School, to collect and process the data
indicated herein for the purpose of contact tracing effecting contro of the COVID-19
transmission. I understand that my personal information is protected by RA 10173 or
the Data Privacy Act of 2012 and that this form will be destroyed 30 days from date of
accomplishment, following the National Archives of the Philippines protocol.
I hereby authorize Mactan National High School, to collect and process the data
indicated herein for the purpose of contact tracing effecting contro of the COVID-19
transmission. I understand that my personal information is protected by RA 10173 or
the Data Privacy Act of 2012 and that this form will be destroyed 30 days from date of
accomplishment, following the National Archives of the Philippines protocol.

Signature:__________________________ Signature:__________________________ Signature:__________________________